National Coordinator for Health IT launches “NHIN Direct”

The Office of the National Coordinator for Health IT launched "NHIN Direct" as a simpler way for physicians and consumers to exchange health information than through implementation of the full-blown Nationwide Health Information Network.

NHIN Direct would use "lightweight" versions of the current standards and services of the NHIN to enable small providers to exchange information securely through the Internet "without having too much technology overhead," said Doug Fridsma, a senior ONC adviser who is serving as acting director of ONC's Office of Interoperability and Standards.

He outlined the initiative at a NHIN forum sponsored by the National eHealth Collaborative on Feb. 22. ONC will announce more details next week.

ONC hopes that will help to broaden participation in the NHIN in order to meet meaningful use requirements for electronic health records, he said.

Providers could use NHIN Direct for exchanges of test results from the lab to the provider, medication reconciliation and summary of care record and transition of care referral between providers. It will also supply the foundation services and standards to support patient engagement and public health.

For example, a provider exchanging a patient summary with another provider may require just a few standards.

"That is different from a query by a physician through the NHIN for information about an unconscious patient in the emergency room," Fridsma said.

To shape the new effort, ONC adopted recommendations made by the Health IT Policy Committee's NHIN work group, an advisory group.

It recently recommended standards and services that include authentication for identity assurance, directories for addressing, secure transport and routing. A variety of existing organizations such as health systems, vendors and information exchange providers could perform the services.

NHIN Direct services would aim to help providers who may not have the technical wherewithal to use the NHIN Connect software, or who have encountered problems using it or executing a legal agreement called the data use and reciprocal sharing agreement (DURSA), Fridsma said.

"Ultimately, we believe there are going to be heterogeneous and multiple ways of exchanging information," he said. "We need both the NHIN Direct and current limited production exchange to support different kinds of exchange and use cases."

ONC will take a coordinating role in NHIN Direct and work with consumer, industry and public organizations to decide on the standards and services, which must be compatible with the existing NHIN.

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